Trends and More from the RSNA Floor
by Jeanne-Marie Phillips
Trends come and go – even in medicine. But certain areas have dominated the RSNA exhibit floor and sessions for several years. Here, we present a review of some of the most important topics RSNA that seem to have staying power.
That said, changes to the political and healthcare landscape resulting from the election were the major focus of discussion. As we all know, this year that could change everything at a dizzying pace.
Software Bigger News than Hardware
It used to be that radiology was a hardware-driven field with film-based x-ray machines, once-revolutionary MRI and CT scanners and new features and twists on these evolving technologies.
But no more. As the imaging world has gone digital throughout, software has taken center stage to help improve diagnostic precision and accuracy of a plethora of modalities. “Digital imaging technologies acquire so much data that enhanced analysis makes a major difference,” commented one experienced radiologist. “We’ve truly evolved into a computer-driven age.” Accordingly much of this year’s innovation was measured in bits and bytes. Of course, the potential for big data to help guide clinical decision making also is enormous, as well as its ability to keep the wheels of any radiology practice efficiently turning.
Another related trend is the ongoing focus on interoperability. Hospitals are demanding it, and vendors are listening. As computer systems play a key role in every aspect of medical imaging, many hospitals and imaging practices simply will no longer accept the proprietary formats and silos of data that have been synonymous with healthcare for too long. Vendors, it seems, are finally listening, with many touting their open systems and ability to integrate with a wide range of downstream software to share information hospital-wide and create a more complete patient picture for more informed care.
The Age of Machine Learning
As part of this trend, not surprisingly, artificial intelligence (AI) technology made a big impact at RSNA this year in both scientific sessions and throughout the exhibit hall. Those who attended the scientific sessions and visited the posters and education exhibits were able to witness firsthand the rapid development of machine learning — particularly deep learning — for a wide range of radiology applications. Researchers presented data on how machine learning offers potential for enhancing image interpretation, such as in breast imaging for quantifying breast cancer risk. Additionally, it holds potential to help segment and measure lesions, reduce unneeded breast biopsies, interpret chest x-rays, detect osteoporosis on CT exams and much more.
Vendor Neutral Archiving
Enterprise multi-format imaging has been a major focus for several years now, but how many sites are truly implementing VNAs and other technology to centralize multi-format image storage and allow access to physicians across the enterprise? Vendors continue to introduce new platforms, but adoption at all but the largest institutions lags behind. Many have sounded the death knell for PACS, yet the PACS replacement market is still around and a growing number of vendors are beefing up their PACS data migration services.
Printing in 3D
The word is out…in surgical planning, physician training and patient education, 3D printed models are one of today’s hot trends, and everyone wants to participate.
This year, RSNA 2016 offered three full-day firsthand participation workshops in 3D printing. Attendance was strong, well up over last year. Scientific sessions focused on how to create models for surgery and education. This year also marked the start of an RSNA special interest group dedicated to furthering use of 3D technology and educating imaging centers on how to create in-house 3D labs. The group is open to all interested, including commercial firms. The group even offers subcommittees to standardize 3D printing and can help troubleshoot problems. Just post a question to this group and someone will answer.
Digital Breast Tomosynthesis
Digital breast tomosynthesis (DBT) has been growing rapidly since its introduction. Not only is it enhancing imaging interpretation precision, but it is also rewriting the rules on how breast screening is conducted in major ways, according to research presented at RSNA 2016.
Surveys show the technology helps improve radiologists’ confidence with findings such as architectural distortion, while also making exams more efficient. And it’s effective across the board for women of all ages and breast densities.
Aunt Minnie reports a study in which researchers “measured the volume of screening and diagnostic mammograms over three one-year intervals. They found that the number of screening mammograms increased by 17% and diagnostic mammograms decreased by 29%, suggesting that the screening exams were more effective. The study also found that the percentage of screening patients receiving immediate results increased from 18% in the first year to 46% in the third, and the percentage of diagnostic patients imaged with only four routine views increased from 24% in the first year to 73% in the third.” The process was also much more efficient for radiologists.
The thought is that as a result, DBT will also affect how cancer screening is practiced – and this change will affect everything from patient scheduling to breast center efficiency, staffing and patient satisfaction.
Do you have a patient portal yet? Likewise patients are demanding the same easy access to information as physicians, not just in radiology but in any medical field. Portals and related systems that provide patients with direct access to medical data is a major trend. Now, more and more patients are not only expecting this not only for timely exam results, but also scheduling appointments, checking on billing issues and much more.
Unfortunately, as the digital world grows, so too do security threats. Cyber security, particularly in cloud-based systems, was another area of interest shared by many. Many IT specialists agree that while the cloud offers tremendous benefits for communicating information beyond the enterprise, appropriate security lags far behind. “We’ve seen so many hackings and breeches,” commented one security consultant, “that it seems clear we need better ways to protect medical data. It’s not only a privacy issue, but important medical information can be held hostage or just disappear.”